International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
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IJCRR - Vol 05 Issue 18, September, 2013

Pages: 26-34

Date of Publication: 25-Sep-2013


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CHLORHEXIDINE - A MIRACLE CHEMICAL

Author: Paavai Ilango, M. Arulpari, Mary Medona , T. Abirami

Category: Healthcare

Abstract:Chlorhexidine is a broad-spectrum antiseptic. It is recognized as Gold standard against which other antiplaque and antigingivitis agents are being compared. We are using it on medical devices and for skin preparation prior to procedures. It is well tolerated by patients and is a true life-saver in terms of prevention of infection and \"multi-drug resistant organisms\". Hence it can be called as a \"Miracle Chemical\". This article clearly suggests the properties and limitations of this miracle molecule \"Chlorhexidine\" ensuring the maximum efficacy and the minimum side effects of the agent. Thus, this is one unique chemical which is considered as the past, present and future agent in the ever-growing field of clinical periodontics.

Keywords: Chlorhexidine, Antimicrobial, Antigingivitis, Antiplaque agent, Mouth wash, Antiseptic.

Full Text:

INTRODUCTION

Chlorhexidine is a cationic bisbiguanide that has been used as a broad-spectrum antiseptic in medicine since 1950’s. Its ability to inhibit the formation and development of bacterial plaque was demonstrated in 1970’s. It is the most effective antiplaque, antigingivitis agent. [1]

Structure

It is symmetrical molecule consisting of two 4 chlorophenyl rings, two biguanide groups and a central hexamethylene bridge connecting chlorophenyl and biguanide group. (Fig.1)

After 20 years of use by the dental profession, chlorhexidine is recognized as the Gold standard against which other antiplaque and gingivitis agents are measured. Chlorhexidine's antiplaque effect is a result of the dicationic nature of the chlorhexidine molecule, which affords the agent the property of persistence of antimicrobial effect at the tooth surface, through both bactericidal and bacteriostatic effects.

Mechanism of action

Chlorhexidine is a broad-spectrum biocide effective against Gram positive bacteria, Gram negative bacteria and fungi [16]. Chlorhexidine inactivates microorganisms with a broader spectrum than other antimicrobials (e.g. antibiotics) and has a quicker kill rate than other antimicrobials (e.g. povidone-iodine). Based on its concentration, it has an immediate bactericidal action and a prolonged bacteriostatic action due to adsorption onto the pellicle-coated enamel surface [10]. Chlorhexidine kills by disrupting the cell membrane. [28] (Fig. 2)

Effect on bacteria

Chlorhexidine is a positively charged molecule that binds to the negatively charged sites on the cell wall; it destabilizes the cell wall and interferes with osmosis. [22] The bacterial uptake of the chlorhexidine is very rapid, typically working within 20 seconds. In low concentration, it affects the integrity of the cell wall. Once the cell wall is damaged, it crosses into the cell itself and attacks the cytoplasm membrane. Damage to the cytoplasm's delicate semi permeable membrane allows for leakage of components leading to cell death. In high concentration chlorhexidine solidifies the cytoplasm. (Fig. 3)

Effect on fungi

Fungi uptakes chlorhexidine in a short period of time and the mechanism of action is very similar to bacteria.

Effect on biofilm

Bio films are a complex aggregation of microorganisms growing on a solid substrate. They can occur on organic (e.g. dental plaque) or inorganic surfaces. This matrix protects the cells within it and increases their resistance to antimicrobials. Many antimicrobial agents have a difficult time eliminating organisms in a bio film. Chlorhexidine has shown some ability to help inhibit adherence of microorganisms to a surface thereby preventing growth and development of bio films. [14]

Effects on other microbial organisms

This includes bacterial spores and protozoa. It has also shown activity against enveloped viruses in vitro (e.g., herpes simplex virus, HIV, cytomegalovirus, influenza. But has substantially less activity against nonenveloped viruses (e.g., rotavirus, adenovirus, and enteroviruses). [11]

Effect on skin, mucous membrane

In topical applications, chlorhexidine is shown to have the unique ability to bind to the proteins present in human tissues with limited systemic absorption. Protein bound chlorhexidine releases slowly leading to prolonged activity. This phenomenon is known as substantivity [18] and allows for a longer duration of antimicrobial action against a broad spectrum of bacteria and fungi. In fact, it's antimicrobial activity has been documented to last at least 48 hours on the skin. [7][18] Unlike povidone-iodine, it is not affected by the presence of body fluids such as blood.

Effect on medical equipments

Chlorhexidine has also been applied to medical devices such as dental implants, vascular catheters, needleless connectors and antimicrobial dressings to kill organisms and protect against microbial colonization and subsequently bio film development.

Deactivation

Chlorhexidine is deactivated by anionic compounds, including the anionic surfactants commonly used as detergents in toothpastes and mouthwashes, anionic thickeners such as carbomer. For this reason, chlorhexidine mouth rinses should be used at least 30 minutes after other dental products [4].  For best effectiveness, food, drink, smoking, and mouth rinses should be avoided for at least one hour after use. If it is not deactivated, chlorhexidine lasts longer in the mouth than other mouthwashes and this is partly why it is to be preferred over other treatments for gingivitis.

Safety

Chlorhexidine is harmful in high concentrations, but is used safely in low concentrations in many products, such as mouthwash and contact lens solution. However, numerous scientific papers have reported complications with low level exposure too. In UK, the Medicines and Health Care Products Regulatory Agency (MHRA) has issued a patient safety alert on the risk of anaphylactic reactions from the use of medical devices and medicinal products containing chlorhexidine. Adequate and well-controlled studies in pregnant women have not been done, so this drug should be used during pregnancy only if clearly needed. Caution should be exercised when chlorhexidine is administered to a nursing woman. Ingestion of 3-6ml of chlorhexidine by a small child (~10 kg body weight) might result in gastric distress, including nausea, or signs of alcohol intoxication. Medical attention should be sought if more than 12ml of chlorhexidine is ingested by a small child or if signs of alcohol intoxication develop.

Availability

Chlorhexidine is present in various forms such as oral rinses (0.2% and 0.12% concentration), skin cleansers, Gauze dressings, pre-operative skin preparation, surgical scrub, spray, rubbing agent, gel with and without combination of fluoride, soap, face wash, varnish, local drug delivery, chewing gums and in small quantities it is used as a preservative.(fig.4) As a mouth-rinse, chlorhexidine is sometimes marketed under the brand names Clohex, Foam Safe, Hexicleans, Peridex, and Perichlor. It is also available as a chlorhexidine-chip (PerioChip) in the UK, USA and in Germany. Quinoderm face wash is the brand name for its face wash. Its spray products are mainly marketed under the brand name Corsodyl. It is marketed as ethanol in Italy, Switzerland and other European countries, Chlorhexamed in Germany, Savacol in Australia and New Zealand, clohex in India,  Perioxidina in Venezuela, chlorhex in UK. As a skin cleanser, it is marketed under brand names such as Hibiclens, Savinox plus or Dexidin. Surgical hand wash is marketed under the brand name Hexigard. It is also used in some acne skin washes. It is also used as part of a treatment for athlete's foot. In some countries, it is available by prescription only.

Various forms of chlorhexidine

Chlorhexidine mouth wash  

Indications

  • Antiplaque and antigingivitis agent.
  • It is used to improve bad breath. Morning halitosis is reduced up to 90%.[27]
  • Improves gingival health for short periods in the absence of any mechanical oral hygiene procedure.[15]
  • It is used between dental visits as part of a professional program for the treatment of gingivitis [6].
  • It  may also be of some prophylactic value against oral candidial infections.[5]
  • It decrease the speed and degree to which recurrence of drug-induced gingival enlargement occurs.[24]
  • During the first postoperative week after a  periodontal surgery, patient advised to use  twice daily to maintain good oral hygiene.[19]
  • It may help to reduce the  mucositis.[23]
  • There are oral pathologic conditions like oral cysts, dental traumas etc. in which the maintenance of oral hygiene is required for healing and regeneration of the oral tissues [29] [30].

Side effects

The most common side effects are:

  • An increase in staining of teeth and other oral surfaces including silicate and resin restorations due to continued use for long periods. [13] This brownish discoloration of teeth and tongue are due to the fact that the disintegration of bacterial membranes leads to the denaturation of bacterial proteins [8]. Other discolorations might be caused by monosaccharide’s such as glucose and fructose that are dissolved in saliva and that react with the amine functions of bacterial proteins.(Maillard reaction)[8].
  • An increase in calculus formation,
  • An alteration in taste perception[12]
  • Minor irritation and superficial desquamation of the oral mucosa.
  • Parotid gland swelling and inflammation of the salivary glands (sialadenitis).
  • Frequently reported oral mucosal symptoms are Stomatitis, Gingivitis, Glossitis, Ulcer, Dry mouth, Hypesthesia, Glossal edema, Paresthesia.

Study comparing efficacy of two different concentrations of chlorhexidine mouth-rinse on plaque re growth suggests both are almost equally effective for their plaque inhibiting capacity. [9]

Study evaluating the role of chlorhexidine in caries prevention suggests that it has not been highly effective in preventing caries. [3]

Topical     chlorhexidine

Chlorhexidine is used as a topical antiseptic skin scrub in hospital and household settings. It is also used for general skin cleansing, surgical scrub, pre-operative skin preparation and as a rubbing agent prior to the use of hypodermic or intravenous needles in place of iodine.  (Fig. 5)

It is contraindicated for use near the meninges, in body cavities, and near the eyes and ears because at 2% concentration, it can cause serious and permanent injury.

Chlorhexidine Spray

It acts as an antiseptic and disinfectant agent. It kills micro-organisms in the areas it is in contact with.

Indications

  • Aid for preventing build-up of plaque on the teeth and maintaining oral hygiene.
  • Prevention and treatment of gingivitis.
  • Promoting gum healing after dental surgery.
  • Management of apthous ulcers.
  • Management of candidiasis.
  • Management of inflammation of the lining of the mouth due to denture irritation.

Side effects

  • Temporary taste disturbance.
  • Burning sensation on the tongue.
  • Brown, non-permanent staining of the teeth avoided by brushing the teeth before using the spray.
  • Peeling inside the mouth.
  • Swelling of the salivary glands.
  • Skin irritation.

Study comparing chlorhexidine spray and mouthwash in the control of dental plaque after periodontal surgery indicates that the efficacy of CHX spray in the post-surgical control of dental plaque is not different from that of CHX mouthwash , but, tooth staining on the contrary was significantly lower in the group using CHX spray[12].

Chlorhexidine gel

It acts as an antiseptic and disinfectant agent. One inch of gel should be used to brush the teeth once or twice a day for about a minute. The brushing aids in both mechanical and chemical plaque control. Indications and side effects are similar to that of spray. It additionally helps in preventing tooth decay in people at high risk, for example people with a dry mouth due to poorly functioning salivary glands (xerostomia).

Chlor-fluro gel

It is used on trays or tooth brush or direct application. It is available in 30 and 250 ml with the composition of 0.2% of chlorhexidine gluconate and 0.003% of sodium fluoride. Chlorhexidine helps control plaque and eases localised gingival and oral infections whereas Fluoride ions present are taken up by tooth structure and help to increase resistance to dental caries [20].

Indications

  • Used for the control of minor infections and to ease associated discomfort. 
  •  Used as an aid to oral hygiene after oral surgical procedures or jaw fixation. 
  •  Used to control plaque growth on RPD or orthodontic appliances.

Contraindications

  • Not recommended for people who cannot expectorate.

Directions to use

Place approximately 1cm on toothbrush, brush thoroughly spit out. No rinsing for approximately 15 minutes once a day.

When using a tray system place a small amount of gel in each tooth segment, gently seat tray into mouth. To achieve full benefit, keep tray seated in the mouth for 1 hour.

Chlorhexidine Soap

It is used to reduce the germs on your skin. It works for a longer time than other soaps and it works when other body fluids such as blood are present. It is found to be more active against Hospital Acquired Infections.

Study evaluating effect of daily chlorhexidine bathing on hospital-acquired infection reveals daily bathing with chlorhexidine-impregnated washcloths significantly reduced the risks of acquisition of MDROs and development of hospital-acquired bloodstream infections [21].

Side effects

Itchiness, redness, and irritation of the skin. But, these side effects often go away quickly. 

Chlorhexidine face wash

It has an antibacterial action and prevents spots in the face. Composition includes Chlorhexidine gluconate 0.15% and cetrimide 1.5%.  (Fig.6)

Chlorhexidine varnish

The protective varnish containing chlorhexidine and thymol protects exposed root surfaces and controls bacteria.

Indications

  • Protection of exposed root surface
  • Treatment of open dentin tubules
  • Bacterial control in patients e.g. Ortho patients
  • Inadequate oral hygiene
  • Gingivitis

Study evaluating the use of chlorhexidine varnishes in preventing and treating periodontal disease indicates that the application of varnishes seems to have beneficial effects in patients with chronic gingivitis, improving their plaque accumulation and bleeding levels and reducing their gingival index. It also suggests that it is possible to maintain beneficial effect for prolonged periods of time, although this requires re-applications of the varnish. Additionally, sub gingival application of high-concentration varnishes following SRP gives greater reductions in pocket depth than those obtained solely by mechanical treatment of the pockets [17].

Local drug delivery of Chlorhexidine

Periochip is a small chip (4.0*5.0*0.35mm) composed of biodegradable hydrolyzed gelatin matrix, cross linked with gluteraldehyde and also containing glycerine and water, into which 2.5mg of chlorhexidine gluconate (36%) has been incorporated. This delivery system releases chlorhexidine and maintains drug concentration in GCF for at least 7 days. [26]

Availability

Periochip 2.5mg is supplied as a small, orange-brown rectangular chip. It is supplied in cartoons of 10 and 20 chips. Each chip is individually packed in a separate compartment of an aluminum blister pack.

Indications

  • Adjunct to scaling and root planning for reduction of pocket depth.
  • Used as a part of a periodontal maintenance program.

Dosage and administration

1 periochip is inserted into a periodontal pocket with probing pocket depth 5mm. Up to 8 periochips may be inserted in a single visit.

Chlorhexidine chewing gums

Chewing gum as a delivery system for various topical dental prophylactic and therapeutic agents has been repeatedly studied. A few dental chewing gum products are registered and marketed in various countries. Thus, there are gums containing fluoride, enzymes, mineral salts, metal salts, xylitol, carbamide and CHX diacetate. Chlorhexidine containing chewing gum consists of 5 mg of chlorhexidine diacetate.

Indications

  • To fight against plaque and gingivitis.
  •  Valid choice for persons with high caries activity in general and especially for oligosialic (hyposalivary) and xerostomic patients.
  • To fight against halitosis and before and after undergoing periodontal therapy as an adjunct to other oral hygiene measures.
  • Used by all persons temporarily unable to perform mechanical oral hygiene for whatever reason.

 

References:

  1. Addy M, Moran JM. Periodontal 2000 15:52,1997
  2. American dental association, guide to dental therapeutics, ed 2, chicago, 2000, ad.
  3. Autio-gold.J, Operative dentistry 33 (6): 710–6 (2008)..
  4. Denton, Graham W,  Lippincott williams and wilkins. Pp. 321–36(2000).
  5. Epstein JB, oral surg oral med path 69:32,1990.
  6. Gaffar, A,Afflitto.J; Nabi, European journal of oral sciences 105(1997),   .
  7. Hibbard J , Journal of infusion nursing; 28(3): 194-207, 2005.
  8. Hjeljord.G, Rolla.G; Bonesvoll.P, Journal of periodontal research. Supplement 12: 11-6 (1973).
  9. Indian journal of dentistry, volume 2, issue 2 , pages 11-15, june 2011.
  10. Jenkins.S, Addy.M, Wade.W, Journal of clinical periodontology 15 (7): 415–24, (1988).
  11. John .M,Boyce and Didier Pittet.cdc, 25 oct. 2002. Web. 8 aug. 2013.
  12. Journal of clinical periodontology ,volume 27, issue 6, pages 425–430, june 2000
  13. Lang NP et al . J periodontal res 17:101,198
  14. Lim.KS. And P. A. A. Kam, Anaesthesia and intensive care 36.4 (2008).
  15. Löe H, Schiött CR, J periodontal res  5:79 ,1970
  16. Mcdonnell, Gerald and A.Denver russell. Clinical microbiology reviews 12.1 (1999):147-79. Print.
  17. Med oral patol oral cir bucal. apr1;13(4):e257-60,2008.
  18. Mohammadi.Z and P.V. Abbott. International endodontic journal 42.4, 288-302 (2009).
  19.  Newman .MG, et al, J periodontal 60:577, 1989.
  20. Operative dentistry, Nov-dec; 33(6):710-6. 2008. Doi: 10.2341/08-3.
  21. Original article the new england journal of medicine; 368:533-542february 7, 2013doi: 10.1056/nejmoa1113849.
  22. Puig silla M, Montiel Company JM, Almerich Silla JM. Med oral patol oral cir bucal; 13:e257 60, 2008.
  23. Raether.D, Walker P, et al. Pediatr dent 11:37,1989
  24. Saravia ME ,Svirsky JA, Friedman R,  dent child 57:366,1990
  25. Schweiz monatsschr zahnmed,chlorhexidine-containing chewing gum.  Clinical documentation. 116: 476–483 (2006)
  26. Soskolne WA , Haesman PA, et al , J periodontal 68:32,1997
  27. Van steenberghe D, et al, J periodontal 72:1183,2001
  28. WHO, 2009. Web. 13 aug. 2012
  29. Zadik, yehuda (2008). Dental traumatology 24 (6): 698–701.
  30. Zadik, yehuda; yitschaky, oded,(2011), journal of oral and maxillofacial surgery 69 (7): e282–4

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One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

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This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

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‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Humaira Tahir et al. entitled "Comparison of First Analgesic Demand after Major Surgeries of Obstetrics and Gynecology between Pre-Emptive Versus Intra-Operative Groups by Using Intravenous Paracetamol: A Cross-Sectional Study" is awarded Best Article for Vol 14 issue 14
A Study by Monica K. entitled "Risk Predictors for Lymphoma Development in Sjogren Syndrome - A Systematic Review" is awarded Best Article for Vol 14 issue 13
A Study by Mokhtar M Sh et al. entitled "Prevalence of Hospital Mortality of Critically Ill Elderly Patients" is awarded Best Article for Vol 14 issue 12
A Study by Vidya S. Bhat et al. entitled "Effect of an Indigenous Cleanser on the Microbial Biofilm on Acrylic Denture Base - A Pilot Study" is awarded Best Article for Vol 14 issue 11
A Study by Pandya S. et al. entitled "Acute and 28-Day Repeated Dose Subacute Toxicological Evaluation of Coroprotect Tablet in Rodents" is awarded Best Article for Vol 14 issue 10
A Study by Muhammad Zaki et al. entitled "Effect of Hemoglobin Level on the Severity of Acute Bronchiolitis in Children: A Case-Control Study" is awarded Best Article for Vol 14 issue 09
A Study by Vinita S & Ayushi S entitled "Role of Colour Doppler and Transvaginal Sonography for diagnosis of endometrial pathology in women presenting with Abnormal Uterine Bleeding" is awarded Best Article for Vol 14 issue 08
A Study by Prabhu A et al. entitled "Awareness of Common Eye Conditions among the ASHA (Accredited Social Health Activist) Workers in the Rural Communities of Udupi District- A Pilot Study" is awarded Best Article for Vol 14 issue 07
A Study by Divya MP et al. entitled "Non-Echoplanar Diffusion-Weighted Imaging and 3D Fiesta Magnetic Resonance Imaging Sequences with High Resolution Computed Tomography Temporal Bone in Assessment and Predicting the Outcome of Chronic Suppurative Otitis Media with Cholesteatoma" is awarded Best Article for Vol 14 issue 06
A Study by Zahoor Illahi Soomro et al. entitled "Functional Outcomes of Fracture Distal Radius after Fixation with Two Different Plates: A Retrospective Comparative Study" is awarded Best Article for Vol 14 issue 05
A Study by Ajai KG & Athira KN entitled "Patients’ Gratification Towards Service Delivery Among Government Hospitals with Particular Orientation Towards Primary Health Centres" is awarded Best Article for Vol 14 issue 04
A Study by Mbungu Mulaila AP et al. entitled "Ovarian Pregnancy in Kindu City, D.R. Congo - A Case Report" is awarded Best Article for Vol 14 issue 03
A Study by Maryam MJ et al. entitled "Evaluation Serum Chemerin and Visfatin Levels with Rheumatoid Arthritis: Possible Diagnostic Biomarkers" is awarded Best Article for Vol 14 issue 02
A Study by Shanthan KR et al. entitled "Comparison of Ultrasound Guided Versus Nerve Stimulator Guided Technique of Supraclavicular Brachial Plexus Block in Patients Undergoing Upper Limb Surgeries" is awarded Best Article for Vol 14 issue 01
A Study by Amol Sanap et al. entitled "The Outcome of Coxofemoral Bypass Using Cemented Bipolar Hemiarthroplasty in the Treatment of Unstable Intertrochanteric Fracture of Femur in a Rural Setup" is awarded Best Article Award of Vol 13 issue 24
A Study by Manoj KP et al. entitled "A Randomized Comparative Clinical Trial to Know the Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block Against Multimodal Analgesia for Postoperative Analgesia Following Caesarean Section" is awarded Best Article Award of Vol 13 issue 23
A Study by Karimova II et al. entitled "Changes in the Activity of Intestinal Carbohydrases in Alloxan-Induced Diabetic Rats and Their Correction with Prenalon" is awarded Best Article of Vol 13 issue 22
A Study by Ashish B Roge et al. entitled "Development, Validation of RP-HPLC Method and GC MS Analysis of Desloratadine HCL and It’s Degradation Products" is awarded Best Article of Vol 13 issue 21
A Study by Isha Gaurav et al. entitled "Association of ABO Blood Group with Oral Cancer and Precancer – A Case-control Study" is awarded Best Article for Vol 13 issue 20
A Study by Amr Y. Zakaria et al. entitled "Single Nucleotide Polymorphisms of ATP-Binding Cassette Gene(ABCC3 rs4793665) affect High Dose Methotrexate-Induced Nephrotoxicity in Children with Osteosarcoma" is awarded Best Article for Vol 13 issue 19
A Study by Kholis Ernawati et al. entitled "The Utilization of Mobile-Based Information Technology in the Management of Dengue Fever in the Community Year 2019-2020: Systematic Review" is awarded Best Article for Vol 13 issue 18
A Study by Bhat Asifa et al. entitled "Efficacy of Modified Carbapenem Inactivation Method for Carbapenemase Detection and Comparative Evaluation with Polymerase Chain Reaction for the Identification of Carbapenemase Producing Klebsiella pneumonia Isolates" is awarded Best Article for Vol 13 issue 17
A Study by Gupta R. et al. entitled "A Clinical Study of Paediatric Tracheostomy: Our Experience in a Tertiary Care Hospital in North India" is awarded Best Article for Vol 13 issue 16
A Study by Chandran Anand et al. entitled "A Prospective Study on Assessment of Quality of Life of Patients Receiving Sorafenib for Hepatocellular Carcinoma" is awarded Best article for Vol 13 issue 15
A Study by Rosa PS et al. entitled "Emotional State Due to the Covid – 19 Pandemic in People Residing in a Vulnerable Area in North Lima" is awarded Best Article for Vol 13 issue 14
A Study by Suvarna Sunder J et al. entitled "Endodontic Revascularization of Necrotic Permanent Anterior Tooth with Platelet Rich Fibrin, Platelet Rich Plasma, and Blood Clot - A Comparative Study" is awarded Best Article for Vol 13 issue 13
A Study by Mona Isam Eldin Osman et al. entitled "Psychological Impact and Risk Factors of Sexual Abuse on Sudanese Children in Khartoum State" is awarded Best Article for Vol 13 issue 12
A Study by Khaw Ming Sheng & Sathiapriya Ramiah entitled "Web Based Suicide Prevention Application for Patients Suffering from Depression" is awarded Best Article for Vol 13 issue 11
A Study by Purushottam S. G. et al. entitled "Development of Fenofibrate Solid Dispersions for the Plausible Aqueous Solubility Augmentation of this BCS Class-II Drug" is awarded Best article for Vol 13 issue 10
A Study by Kumar S. et al. entitled "A Study on Clinical Spectrum, Laboratory Profile, Complications and Outcome of Pediatric Scrub Typhus Patients Admitted to an Intensive Care Unit from a Tertiary Care Hospital from Eastern India" is awarded Best Article for Vol 13 issue 09
A Study by Mardhiah Kamaruddin et al. entitled "The Pattern of Creatinine Clearance in Gestational and Chronic Hypertension Women from the Third Trimester to 12 Weeks Postpartum" is awarded Best Article for Vol 13 issue 08
A Study by Sarmila G. B. et al. entitled "Study to Compare the Efficacy of Orally Administered Melatonin and Clonidine for Attenuation of Hemodynamic Response During Laryngoscopy and Endotracheal Intubation in Gastrointestinal Surgeries" is awarded Best Article for Vol 13 issue 07
A Study by M. Muthu Uma Maheswari et al. entitled "A Study on C-reactive Protein and Liver Function Tests in Laboratory RT-PCR Positive Covid-19 Patients in a Tertiary Care Centre – A Retrospective Study" is awarded Best Article of Vol 13 issue 06 Special issue Modern approaches for diagnosis of COVID-19 and current status of awareness
A Study by Gainneos PD et al. entitled "A Comparative Evaluation of the Levels of Salivary IgA in HIV Affected Children and the Children of the General Population within the Age Group of 9 – 12 Years – A Cross-Sectional Study" is awarded Best Article of Vol 13 issue 05 Special issue on Recent Advances in Dentistry for better Oral Health
A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" is awarded Best Article of Vol 13 issue 06
A Study by Chen YY and Ghazali SRB entitled "Lifetime Trauma, posttraumatic stress disorder Symptoms and Early Adolescence Risk Factors for Poor Physical Health Outcome Among Malaysian Adolescents" is awarded Best Article of Vol 13 issue 04 Special issue on Current Updates in Plant Biology to Medicine to Healthcare Awareness in Malaysia
A Study by Kumari PM et al. entitled "Study to Evaluate the Adverse Drug Reactions in a Tertiary Care Teaching Hospital in Tamilnadu - A Cross-Sectional Study" is awarded Best Article for Vol 13 issue 05
A Study by Anu et al. entitled "Effectiveness of Cytological Scoring Systems for Evaluation of Breast Lesion Cytology with its Histopathological Correlation" is awarded Best Article of Vol 13 issue 04
A Study by Sharipov R. Kh. et al. entitled "Interaction of Correction of Lipid Peroxidation Disorders with Oxibral" is awarded Best Article of Vol 13 issue 03
A Study by Tarek Elwakil et al. entitled "Led Light Photobiomodulation Effect on Wound Healing Combined with Phenytoin in Mice Model" is awarded Best Article of Vol 13 issue 02
A Study by Mohita Ray et al. entitled "Accuracy of Intra-Operative Frozen Section Consultation of Gastrointestinal Biopsy Samples in Correlation with the Final Histopathological Diagnosis" is awarded Best Article for Vol 13 issue 01
A Study by Badritdinova MN et al. entitled "Peculiarities of a Pain in Patients with Ischemic Heart Disease in the Presence of Individual Combines of the Metabolic Syndrome" is awarded Best Article for Vol 12 issue 24
A Study by Sindhu Priya E S et al. entitled "Neuroprotective activity of Pyrazolone Derivatives Against Paraquat-induced Oxidative Stress and Locomotor Impairment in Drosophila melanogaster" is awarded Best Article for Vol 12 issue 23
A Study by Habiba Suhail et al. entitled "Effect of Majoon Murmakki in Dysmenorrhoea (Usre Tams): A Standard Controlled Clinical Study" is awarded Best Article for Vol 12 issue 22
A Study by Ghaffar UB et al. entitled "Correlation between Height and Foot Length in Saudi Population in Majmaah, Saudi Arabia" is awarded Best Article for Vol 12 issue 21
A Study by Siti Sarah Binti Maidin entitled "Sleep Well: Mobile Application to Address Sleeping Problems" is awarded Best Article for Vol 12 issue 20
A Study by Avijit Singh"Comparison of Post Operative Clinical Outcomes Between “Made in India” TTK Chitra Mechanical Heart Valve Versus St Jude Mechanical Heart Valve in Valve Replacement Surgery" is awarded Best Article for Vol 12 issue 19
A Study by Sonali Banerjee and Mary Mathews N. entitled "Exploring Quality of Life and Perceived Experiences Among Couples Undergoing Fertility Treatment in Western India: A Mixed Methodology" is awarded Best Article for Vol 12 issue 18
A Study by Jabbar Desai et al. entitled "Prevalence of Obstructive Airway Disease in Patients with Ischemic Heart Disease and Hypertension" is awarded Best Article for Vol 12 issue 17
A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09

List of Awardees

A Study by Ese Anibor et al. "Evaluation of Temporomandibular Joint Disorders Among Delta State University Students in Abraka, Nigeria" from Vol 13 issue 16 received Emerging Researcher Award


A Study by Alkhansa Mahmoud et al. entitled "mRNA Expression of Somatostatin Receptors (1-5) in MCF7 and MDA-MB231 Breast Cancer Cells" from Vol 13 issue 06 received Emerging Researcher Award


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International Journal of Current Research and Review (IJCRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

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